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European Spine Journal

, Volume 28, Issue 9, pp 2103–2111 | Cite as

Changes in pelvic anatomy after long corrective fusion using iliac screws for adult spinal deformity

  • Hiroki ObaEmail author
  • Shigeto Ebata
  • Jun Takahashi
  • Shota Ikegami
  • Kensuke Koyama
  • Hiroyuki Kato
  • Hirotaka Haro
  • Tetsuro Ohba
Original Article

Abstract

Purpose

Long fusion to the sacrum with iliac screws can decrease pelvic incidence (PI). Considering the physiological range of movement of the sacroiliac joint, this decrease may be relatively extreme. The purpose of the study was to determine changes in pelvic morphology after orthopedic surgery using long fusion with iliac screws, and examine the relationship between changes in PI and morphology.

Methods

We included data from 80 consecutive patients who underwent corrective surgery for adult spine deformity (72 female and 8 male; mean age: 71.1 years). We examined preoperative and early postoperative full-standing X-ray images and pelvic computed tomography of the patients and compared the following: (1) pre- and postoperative pelvic measurements including PI, (2) correlations between change of PI, iliac angle, and distance between posterior superior iliac spines (DPSIS).

Results

After surgery, PI decreased significantly (− 3.3°, 95% confidence interval [95%CI] − 4.3° to − 2.3°, P < 0.01) and DPSIS increased significantly (+ 2.7 mm, 95%CI 1.7 to 3.8 mm, P < 0.01). By contrast, iliac angle decreased significantly (− 1.4°, 95%CI − 2.1° to − 0.7°, P < 0.01). There were significant correlations between changes of PI and iliac angle (r = 0.34, P < 0.01) and between changes of DPSIS and iliac angle (r =  − 0.44, P < 0.01).

Conclusions

We observed changes in pelvic morphology associated with spinal pelvic correction surgery using iliac screws and changes in pelvic incidence related to these changes in pelvic morphology. We recommend selecting pelvic anchors and surgical procedures considering potential movement of the sacroiliac joint.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.

Keywords

Pelvic Pelvic incidence Sacroiliac joint Long fusion Adult spine deformity 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

586_2019_6027_MOESM1_ESM.pptx (595 kb)
Supplementary file1 (PPTX 594 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Hiroki Oba
    • 1
    • 2
    Email author
  • Shigeto Ebata
    • 1
  • Jun Takahashi
    • 2
  • Shota Ikegami
    • 2
  • Kensuke Koyama
    • 1
  • Hiroyuki Kato
    • 2
  • Hirotaka Haro
    • 1
  • Tetsuro Ohba
    • 1
  1. 1.Department of Orthopaedic Surgery, School of MedicineUniversity of YamanashiChuoJapan
  2. 2.Department of Orthopaedic Surgery, School of MedicineShinshu UniversityMatsumotoJapan

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